Journal of the Chinese Medical Association
Volume 69, Issue 5 , Pages 224-227, May 2006

Imperforate Hymen Complicated with Pyocolpos and Lobar Nephronia

  • Mao-Chang Shen

      Affiliations

    • Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • ,
  • Ling-Yu Yang

      Affiliations

    • Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • Corresponding Author InformationCorrespondence to: Dr. Ling-Yu Yang, Division of Pediatric Nephrology, Department of Pediatrics, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan, R.O.C.

Received 30 September 2005; accepted 26 December 2005.

Article Outline

An imperforate hymen is not a rare condition in female newborns, but is often ignored in a genital examination by physicians. Lobar nephronia is a rare condition in pediatric patients that can be screened by ultrasound or computed tomography to distinguish it from a renal abscess. Treatment for lobar nephronia requires at least 14 days of antimicrobial therapy and a follow-up assessment by renal ultrasonography or dimercaptosuccinic acid scan. We report an unusual case of a 2-year-old girl with an imperforate hymen and pyocolpos. The pyocolpos compressed the left lower ureter to cause hydroureter, hydronephrosis, and nephronia. Partial hymenotomy was performed to drain the pus, and antibiotics were administered for a total of 3 weeks. There was a good outcome. This case demonstrates the need to perform a full physical examination, particularly a genital examination, in newborns. Further, if gynecologic pathology is suspected, then urologic screening studies are recommended to rule out potential associated anomalies.

Key Words:  imperforate hymen , lobar nephronia , pyocolpos

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References 

  1. Heller DS . Lower genital tract disease in children and adolescents: a review . J Pediatr Adolesc Gynecol . 2005;18:75–83
  2. Brevetti LS , Kimura K , Brevetti GR , Lawrence JP , Soper RT . Pyocolpos: diagnosis and treatment . J Pediatr Surg. . 1997;32:110–111
  3. Kahn R , Duncan B , Bowes W . Spontaneous opening of congenital imperforated hymen . J Pediatr . 1975;87:768–770
  4. Rosenberg-Arska M , Visser MR . Enterobacteriaceae . In:  Cohen J ,  Powderly WG ,  Berkley SF ,  Calandra T editor. Cohen & Powderly: Infectious Diseases . 2nd edition. Philadelphia: Mosby; 2004;p. 2199–2201
  5. Uehling DT , Hahnfeld LE , Scanlan KA . Urinary tract abnormalities in children with acute focal bacterial nephritis . BJU Int . 2000;85:885–888
  6. Gold RP , McClennan BL , Rettenberg RR . CT appearance of acute inflammatory diseases of the renal interstitium . Am J Roentgenol . 1983;141:343–349
  7. Soulen MC , Fishman EK , Goldman SM , Gatewood OM . Bacterial renal injection: role of CT . Radiology . 1989;171:703–707
  8. Clautice-Engle T , Jeffrey RB . Renal hypoperfusion: value of power Doppler imaging . Am J Roentgenol . 1997;168:1227–1231
  9. Kline MW , Kaplan SL , Baker CJ . Acute focal bacterial nephritis: diverse clinical presentation in pediatric patients . Pediatr Infect Dis . 1988;7:346–349
  10. Rathore MH , Barton LL , Luisiri A . Acute lobar nephronia: a review . Pediatrics . 1991;87:728–734
  11. Siegel AJ , Glaiser CM . Acute focal bacterial nephritis in children: significance of reflux . Am J Roentgenol . 1981;137:257–260
  12. Rushton HG , Majd M , Jantausch B , Wiedermann BL , Belman AB . Renal scarring following reflux and nonreflux pyelonephritis in children: evaluation with 99mtechnetium -dimercaptosuccinic acid scintigraphy . J Urol . 1992;147:1327–1332
  13. Nosher JL , Tamminen JL , Anorosa JK , Kallich M . Acute focal bacterial nephritis . Am J Kidney Dis . 1988;11:36–42
  14. Benador D , Benador N , Slosman D , Mermillod B , Girardin E . Are younger children at highest risk of renal sequelae after pyelonephritis? . Lancet . 1997;349:17–19

PII: S1726-4901(09)70223-0

doi:10.1016/S1726-4901(09)70223-0

Journal of the Chinese Medical Association
Volume 69, Issue 5 , Pages 224-227, May 2006

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